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| Plan Name | NICE HEALTHCARE LIFE AND ADD PLAN |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | NICE HEALTHCARE MANAGEMENT COMPANY |
| Employer identification number (EIN): | 825347998 |
| NAIC Classification: | 621399 |
| NAIC Description: | Offices of All Other Miscellaneous Health Practitioners |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 504 | 2023-07-01 | ELIZA MEJIA | 2024-11-26 | ||
| 504 | 2022-07-01 | ELIZA MEJIA | 2023-12-21 |
| 2023: NICE HEALTHCARE LIFE AND ADD PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-07-01 | Type of plan entity | Single employer plan |
| 2023-07-01 | Plan funding arrangement – Insurance | Yes |
| 2023-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: NICE HEALTHCARE LIFE AND ADD PLAN 2022 form 5500 responses | ||
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | First time form 5500 has been submitted | Yes |
| 2022-07-01 | Plan funding arrangement – Insurance | Yes |
| 2022-07-01 | Plan benefit arrangement – Insurance | Yes |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |||||||||||||||||||||
| Policy contract number | GLUG0BCZM | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
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| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |||||||||||||||||||||
| Policy contract number | GLUG0BCZM | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
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